EDITORIALS;PUBLIC CITIZEN'S CRITICISM OF JCAHO MISSED THE MARK

In its role as the granddaddy of public-interest organizations, Public Citizen is effective in attracting attention with its explosive charges of misfeasance, malfeasance and incompetence. But when it lobbed serious criticisms at the Joint Commission on Accreditation of Healthcare Organizations, the quality of its research was less than stellar-and it failed to ask the right questions.

Public Citizen's charges came at a recent press conference in Washington where it accused the healthcare accrediting agency of a "clear conflict of interest in its dual role as industry regulator and industry advocate." Furthermore, the group said the JCAHO routinely certifies hospitals it knows have significant quality problems. Such strong charges are good for headline writers but frustrating for those who have substantive concerns about quality healthcare.

For starters, the data the group cited came from documents dating back to 1992, which is an eternity in healthcare and well before the Joint Commission undertook serious efforts to reform itself. The group also suggested its findings came from secret documents unearthed by a former employee. In fact, the Joint Commission each year issues a report on hospital compliance with its standards, and it's available to the press and the general public.

Public Citizen's latest performance was a retread of efforts two years ago to get the federal government to review the JCAHO's power to act as an agent for Medicare certification. But nobody updated the script.

Now, we're not big defenders of the JCAHO. In fact, we have hit them pretty hard on their rather ham-handed efforts to develop performance indicators.

Instead of making flimsy charges based on ancient data, Public Citizen could perform a valuable public service by determining the impact of the action plan the JCAHO adopted in January 1995 at the behest of the commission's 28-member board. If the organization has softened its accreditation process because the provider organizations that financially support the JCAHO kicked up a fuss, that would be serious cause for concern. But in its recent efforts to take aim at the JCAHO, Public Citizen missed the target.